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Medical Teacher Volume 35, 2013 - Issue 4
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Research Article

Fostering students’ reflection about bias in healthcare: Cognitive dissonance and the role of personal and normative standards

Rachael A. HernandezBaylor College of Medicine, USA; RACHAEL HERNANDEZ was a Research Coordinator at Baylor College of Medicine, Office of Undergraduate Medical Education, and is currently a PhD student in Health Communication at Pennsylvania State University. Participatory research interests include community health and social support, adolescent sexual health risk, and communication in a clinical context.
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Paul HaidetThe Pennsylvania State University College of Medicine, USA; DR PAUL HAIDET is an internist, medical educator, and researcher focusing on relationship-centered care and patient-provider communication. He is a Professor of Medicine and the Director of Medical Education Research at Pennsylvania State University College of Medicine.
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Anne C. GillBaylor College of Medicine, USA; DR ANNE C. GILL, an Associate Professor at Baylor College of Medicine in the Departments of Pediatrics and Medical Ethics, is a public health professional, nurse, and medical educator.
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Cayla R. TealBaylor College of Medicine, USA; DR CAYLA R. TEAL, an Assistant Professor in the Department of Medicine, is a mixed-methods educational researcher who studies cross-cultural encounters. She serves as Director of Educational Evaluation and Research for the Office of Undergraduate Medical Education at Baylor College of Medicine.Correspondence[email protected]
Pages e1082-e1089 | Published online: 26 Oct 2012

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Rachael Hernandez. (2023) “It’s Always among Us. I Can’t Act Like It’s Not.”: Women College Students’ Perceptions of Physicians’ Implicit Bias. Health Communication 38:1, pages 50-60.
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Anne C. Gill, Yuanyuan Zhou, Jocelyn T. Greely, Anitra D. Beasley, Joel Purkiss & Malvika Juneja. (2022) Longitudinal outcomes one year following implicit bias training in medical students. Medical Teacher 44:7, pages 744-751.
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Dron M. Mandhana & Victoria Caruso. (2022) Reducing implicit biases in classroom discussions. Communication Teacher 36:2, pages 111-116.
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Cristina M. Gonzalez, Monica L. Lypson & Javeed Sukhera. (2021) Twelve tips for teaching implicit bias recognition and management. Medical Teacher 43:12, pages 1368-1373.
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Jeremy Delamarter & Mikayla Lukkasson. (2021) Affective Homogeneity: The Teaching Expectations of Pre-Service Teachers at CCCU Schools. Journal of Research on Christian Education 30:2, pages 160-183.
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Jenilee Crutcher Williams & Courtney N. Wright. (2020) Developing implicit bias awareness in the communication classroom: From Project Implicit to Jane Elliott's Brown Eye Blue Eye. Communication Teacher 34:4, pages 320-326.
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Charisse M. Loder, Leah Minadeo, Laura Jimenez, Zakiya Luna, Loretta Ross, Nancy Rosenbloom, Caren M. Stalburg & Lisa H. Harris. (2020) Bridging the Expertise of Advocates and Academics to Identify Reproductive Justice Learning Outcomes. Teaching and Learning in Medicine 32:1, pages 11-22.
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Katie F. Leslie, Susan Sawning, M. Ann Shaw, Leslee J. Martin, Ryan C. Simpson, Jennifer E. Stephens & V. Faye Jones. (2018) Changes in medical student implicit attitudes following a health equity curricular intervention. Medical Teacher 40:4, pages 372-378.
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Rachael Hernandez. (2018) Medical Students' Implicit Bias and the Communication of Norms in Medical Education. Teaching and Learning in Medicine 30:1, pages 112-117.
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Paula T. Ross & Monica L. Lypson. (2014) Using Artistic-Narrative to Stimulate Reflection on Physician Bias. Teaching and Learning in Medicine 26:4, pages 344-349.
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CristinaM. Gonzalez, MimiY. Kim & PaulR. Marantz. (2014) Implicit Bias and Its Relation to Health Disparities: A Teaching Program and Survey of Medical Students. Teaching and Learning in Medicine 26:1, pages 64-71.
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Brianne E. Lewis & Akshata R. Naik. (2023) A scoping review to identify and organize literature trends of bias research within medical student and resident education. BMC Medical Education 23:1.
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Celeste S. Royce, Helen Kang Morgan, Laura Baecher-Lind, Susan Cox, Elise N. Everett, Angela Fleming, Scott C. Graziano, Shireen Madani Sims, Christopher Morosky, Jill Sutton & Tammy Sonn. (2023) The time is now: addressing implicit bias in obstetrics and gynecology education. American Journal of Obstetrics and Gynecology 228:4, pages 369-381.
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Delaney Schoenbine, James Gerhart, Katherine A. McLean, Joseph deBettencourt, Farnaz Dadrass, Edwin Molina, Michael Hoerger, Sarah Alonzi & Paul Kent. (2021) Attending Patient Funerals as a Follow-Up Practice of Pediatric Oncologists. Illness, Crisis & Loss 31:1, pages 168-174.
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Ranjev Kainth & Gabriel Reedy. (2023) Transforming Professional Identity in Simulation Debriefing. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare Publish Ahead of Print.
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Paul Gavaza, Bhaktidevi M. Rawal & Patricia Flynn. (2023) An exploratory qualitative study of pharmacy student perspectives of implicit bias in pharmacy practice. Currents in Pharmacy Teaching and Learning 15:1, pages 43-51.
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Julie A. Kruse, Jennifer L. Collins & Margaret Vugrin. (2022) Educational strategies used to improve the knowledge, skills, and attitudes of health care students and providers regarding implicit bias: An integrative review of the literature. International Journal of Nursing Studies Advances 4, pages 100073.
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Monica B. VelaAmarachi I. Erondu, Nichole A. Smith, Monica E. Peek, James N. Woodruff & Marshall H. Chin. (2022) Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annual Review of Public Health 43:1, pages 477-501.
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Yuanyuan Zhou, Joel Purkiss, Malvika Juneja, Jocelyn Greely, Anitra Beasley & Anne Gill. (2022) Dataset: Knowledge and attitude retention following an implicit bias classroom workshop. F1000Research 11, pages 25.
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Olivia Rochelle Joseph, Stuart W. Flint, Rianna Raymond-Williams, Rossby Awadzi & Judith Johnson. (2021) Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings. International Journal of Environmental Research and Public Health 18:23, pages 12771.
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Natalia Rodriguez, Emily Kintzer, Julie List, Monica Lypson, Joseph H. Grochowalski, Paul R. Marantz & Cristina M. Gonzalez. (2021) Implicit Bias Recognition and Management: Tailored Instruction for Faculty. Journal of the National Medical Association 113:5, pages 566-575.
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Esther G. Bankert. (2021) Ways of Knowing Nursing: A Discussion Forum Rubric for Distance Education. International Journal for Human Caring 25:3, pages 206-216.
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Cristina M. Gonzalez, Yuliana S. Noah, Nereida Correa, Heather Archer‐Dyer, Jacqueline Weingarten‐Arams & Javeed Sukhera. (2021) Qualitative analysis of medical student reflections on the implicit association test. Medical Education 55:6, pages 741-748.
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Dotun Ogunyemi. (2021) Defeating Unconscious Bias: The Role of a Structured, Reflective, and Interactive Workshop. Journal of Graduate Medical Education 13:2, pages 189-194.
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Marguerite C. Sendall & Alison Brodie. (2020) Postgraduate health promotion students’ perceptions of at-risk populations: Those who smoke tobacco, are overweight or obese or drink alcohol at hazardous levels. PLOS ONE 15:10, pages e0241076.
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Javeed SukheraChristopher J. WatlingCristina M. Gonzalez. (2020) Implicit Bias in Health Professions: From Recognition to Transformation. Academic Medicine 95:5, pages 717-723.
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Catherine F. Nicholas, Devra Cohen-Tigor, Denise E. LaMarra, Cathy M. Smith, Gayle Gliva-McConvey & Anne Chapin. 2020. Comprehensive Healthcare Simulation: Implementing Best Practices in Standardized Patient Methodology. Comprehensive Healthcare Simulation: Implementing Best Practices in Standardized Patient Methodology 169 201 .
Jeremy Delamarter. (2019) Helping preservice teachers separate fact from fiction. Phi Delta Kappan 101:4, pages 20-25.
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Christine Motzkus, Racquel J. Wells, Xingyue Wang, Sonia Chimienti, Deborah Plummer, Janice Sabin, Jeroan Allison & Suzanne Cashman. (2019) Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching. PLOS ONE 14:11, pages e0225058.
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Alexis Horst, Brian D. Schwartz, Jenifer A. Fisher, Nicole Michels & Lon J. Van Winkle. (2019) Selecting and Performing Service-Learning in a Team-Based Learning Format Fosters Dissonance, Reflective Capacity, Self-Examination, Bias Mitigation, and Compassionate Behavior in Prospective Medical Students. International Journal of Environmental Research and Public Health 16:20, pages 3926.
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Javeed Sukhera, Michael Wodzinski, Maham Rehman & Cristina M. Gonzalez. (2019) The Implicit Association Test in health professions education: A meta-narrative review. Perspectives on Medical Education 8:5, pages 267-275.
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Javeed SukheraMichael WodzinskiAlexandra MilnePim W. TeunissenLorelei LingardChris Watling. (2019) Implicit Bias and the Feedback Paradox: Exploring How Health Professionals Engage With Feedback While Questioning Its Credibility. Academic Medicine 94:8, pages 1204-1210.
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Cristina M. Gonzalez, Maria L. Deno, Emily Kintzer, Paul R. Marantz, Monica L. Lypson & Melissa D. McKee. (2019) A Qualitative Study of New York Medical Student Views on Implicit Bias Instruction: Implications for Curriculum Development. Journal of General Internal Medicine 34:5, pages 692-698.
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Katherine Wolsiefer & Jeff Stone. 2019. Confronting Prejudice and Discrimination. Confronting Prejudice and Discrimination 275 297 .
Em Rabelais. 2019. Diversity and Inclusion in Quality Patient Care. Diversity and Inclusion in Quality Patient Care 171 179 .
Jeremy DelamarterJeremy Delamarter. 2019. Proactive Images for Pre-Service Teachers. Proactive Images for Pre-Service Teachers 119 148 .
Cristina M. GonzalezRamya J. GarbaAlyssa LiguoriPaul R. MarantzM. Diane McKeeMonica L. Lypson. (2018) How to Make or Break Implicit Bias Instruction: Implications for Curriculum Development. Academic Medicine 93:11S, pages S74-S81.
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Javeed SukheraMichael WodzinskiPim W. TeunissenLorelei LingardChris Watling. (2018) Striving While Accepting: Exploring the Relationship Between Identity and Implicit Bias Recognition and Management. Academic Medicine 93:11S, pages S82-S88.
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Javeed Sukhera, Alexandra Milne, Pim W. Teunissen, Lorelei Lingard & Chris Watling. (2018) Adaptive reinventing: implicit bias and the co-construction of social change. Advances in Health Sciences Education 23:3, pages 587-599.
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Nicole D. Avant, Elizabeth Weed, Chloe Connelly, Ana L. Hincapie & Jonathan Penm. (2018) Qualitative Analysis of Student Pharmacists’ Reflections of Harvard’s Race Implicit Association Test. Currents in Pharmacy Teaching and Learning 10:5, pages 611-617.
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Diana J. Burgess, Mary Catherine Beach & Somnath Saha. (2017) Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients. Patient Education and Counseling 100:2, pages 372-376.
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Lorie A. Fridell. (2016) Racial Aspects of Police Shootings. Criminology & Public Policy 15:2, pages 481-489.
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Aidan Byrne & Alessandra Tanesini. (2015) Instilling new habits: addressing implicit bias in healthcare professionals. Advances in Health Sciences Education 20:5, pages 1255-1262.
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Alison S. Clay, Elizabeth Ross, Saumil M. Chudgar, Colleen O’Connor Grochowski, James A. Tulsky & Dan Shapiro. (2015) The emotions of graduating medical students about prior patient care experiences. Patient Education and Counseling 98:3, pages 344-349.
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